Organization Active NPI

Town of Orange Park

Doing business as Orange Park Fire Department

  • Ambulance
  • Orange Park, FL
National Provider Identifier
1639721954
Registry record updated Aug 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AmbulanceTaxonomy code 341600000X
Legal business name
TOWN OF ORANGE PARK
Doing business as
Orange Park Fire Department
Practice address
2025 Smith St
Orange Park, FL 32073-5579
Phone
(904) 264-3411
NPI assigned
Jul 16, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John M Contestabile
Title
Interim Fire Chief
Phone
(904) 278-2083

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulance 341600000X Primary

Addresses

Primary practice location

2025 Smith St
Orange Park, FL 32073-5579

Mailing address

PO Box 161993
Altamonte Springs, FL 32716-1993
Phone (904) 264-3411

Other identifiers 2

IdentifierTypeStateIssuer
104429700MedicaidFL
P02315588OtherFLRAIL ROAD

Other names 1

  • Orange Park Fire Department Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190917001917 FL Part B Supplier - Ambulance Service Supplier 0143559104 Practice locations: Orange Park, FL

National Provider Directory

National Provider Directory

Locations

2025 Smith St
Orange Park, FL 32073
Phone (904) 264-3411

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630022400000",
    "number": "1639721954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 161993",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327161993",
            "telephone_number": "904-264-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 SMITH ST",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735579",
            "telephone_number": "904-264-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF ORANGE PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-16",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A",
        "authorized_official_last_name": "CONTESTABILE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "INTERIM FIRE CHIEF",
        "authorized_official_telephone_number": "904-278-2083"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104429700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD",
            "identifier": "P02315588",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orange Park Fire Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orange Park Fire Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.